West Nile Virus Infection

Pathophysiology: West Nile virus (WNV) is a neurotropic flavivirus that has emerged globally as a significant cause of viral encephalitis. Infection of humans is associated with a febrile illness that can progress to a lethal encephalitis with symptoms including cognitive dysfunction and flaccid paralysis. Seroprevalence studies suggest that while the majority of WNV infections are asymptomatic, approximately 20 to 30% of infected individuals develop flu-like clinical manifestations characterized as WNV fever.

Virology: WNV is one of the Japanese encephalitis antigenic serocomplex of viruses. Image reconstructions and cryoelectron microscopy reveal a 45–50 nm virion covered with a relatively smooth protein surface. This structure is similar to the dengue fever virus; both belong to the genus Flavivirus within the family Flaviviridae.

Diagnosis: In most instances, physicians can diagnose West Nile virus by analyzing a blood sample. A simple blood test can determine whether you have genetic material or antibodies associated with West Nile virus in your blood. If your symptoms are severe and brain-related, your physician may order a lumbar puncture. Also known as a spinal tap, this test involves inserting a needle into your spine to extract fluid.

Treatment: The diagnosis of West Nile virus infection is confirmed with a blood or cerebrospinal fluid test. There is no specific treatment for West Nile virus infection. Intensive supportive therapy is directed toward the complications of brain infections. Anti-inflammatory medications, intravenous fluids, and intensive medical monitoring may be required in severe cases.